New Membership Application

Member dues anniversary date is now based on the date of payment and no longer prorated to a December 1st anniversary date.

Fields with BOLD labels are required

+ Show Member Option Descriptions

Individual  - $125 (currently $150 upon joining, $125 in subsequent years); 1 registered member, 1 login for email and attend events at discounted member rate

Small Corporate  -  $300;  1 registered member, up to 9 logins for email and attending events at discounted member rates

Medium Corporate  -  $400;  2 registered members, up to 99 logins for email and attending events at discounted member rates

Large Corporate  -  $500;  3 registered members, unlimited logins for email and attending events at discounted member rates

Student Members  -  $50.00; 1 login for email and attending events at discounted member rates

Non- Profit - $100.00; 1 registered member, 1 login for email and attend events at discounted member rate if you are employed at a 501(c)(3) organization.

Past President  -  $62.50;1 registered member, 1 login for email and attend events at discounted member rate

Please Make A Selection
Membership Level
Your Payment Will Be:

User Account Set Up
First Name
Last Name
Email
Confirm Email
Password

* Password must be at least 8 characters in length and include; at least 1 capital letter, at least 1 lower case letter and at least 1 number.

Member Information
Organization
Address
City
State
Zip/Postal Code
Phone (000-000-0000)
Mobile (000-000-0000)
Website
Facebook
Google+
Linkedin
Twitter
YouTube
Number of years in business
If you'd like others in your organization to receive email updates from AdFed Suncoast (ex: ADDY info, event alerts, etc.) - please enter their email addresses below.

Corporate Member Option
If signing up for a Medium or Large Corporate Membership, please enter the names and email addresses of your 1 or 2 other designated voting members. Please note, these members cannot be changed for 1 year. Affiliate log-ins can be requested here.

Committee Interests
Please check the committee areas that interest you:
 ADDY Awards  Programs  Communications
 Government Relations      Public Relations  Internet
 Diversity  Public Service  Education
 Membership  Social Media  Sponsorship
 Video  

Business Categories
Which of the following most accurately describes your business? You may select up to two categories.
 Advertising  Public Relations
 In House Marketing Department  Job Placement Agency
 Corporate Marketing Officer  Business Owner/Entrepreneur
 Copywriter  Illustrator
 Art Director/Graphic Designer  Interactive/Web/ Social Media Design    
 Desktop Publishing  Multimedia
 Photographer/Videographer  Research
 Consulting  Broadcast Television
 Cable Television  Internet/Interactive
 Newspaper  Outdoor
 Print Publications/Magazines/Directories      Radio
 Audio-Video Duplication  Pre-Production for Print
 Printing/Duplication  Sales/Trade Show Exhibits
 Screen Printing  Signs/Banners
 Video Production/Post Production      Direct Mail/Fulfillment
 Educational Institution  Government
 Miscellaneous  Specialty Advertising
 Student  

Payment
Payment Method
Card Type
Card Owner's Name
Card Number
CVV
Expiration Date (MM/YYYY)
.

Be sure to click "Submit" one time only.
Clicking "submit" more than once can result in duplicate charges to your credit card.